Nevin Manimala

Virol J. 2022 Jun 16;19(1):103. doi: 10.1186/s12985-022-01830-1.

ABSTRACT

BACKGROUND: As a new epi-center of COVID-19 in Asia and a densely populated developing country, Indonesia is facing unprecedented challenges in public health. SARS-CoV-2 lineage B.1.466.2 was reported to be an indigenous dominant strain in Indonesia (once second only to the Delta variant). However, it remains unclear how this variant evolved and spread within such an archipelagic nation.

METHODS: For statistical description, the spatiotemporal distributions of the B.1.466.2 variant were plotted using the publicly accessible metadata in GISAID. A total of 1302 complete genome sequences of Indonesian B.1.466.2 strains with high coverage were downloaded from the GISAID’s EpiCoV database on 28 August 2021. To determine the molecular evolutionary characteristics, we performed a time-scaled phylogenetic analysis using the maximum likelihood algorithm and called the single nucleotide variants taking the Wuhan-Hu-1 sequence as reference. To investigate the spatiotemporal transmission patterns, we estimated two dynamic parameters (effective population size and effective reproduction number) and reconstructed the phylogeography among different islands.

RESULTS: As of the end of August 2021, nearly 85% of the global SARS-CoV-2 lineage B.1.466.2 sequences (including the first one) were obtained from Indonesia. This variant was estimated to account for over 50% of Indonesia’s daily infections during the period of March-May 2021. The time-scaled phylogeny suggested that SARS-CoV-2 lineage B.1.466.2 circulating in Indonesia might have originated from Java Island in mid-June 2020 and had evolved into two disproportional and distinct sub-lineages. High-frequency non-synonymous mutations were mostly found in the spike and NSP3; the S-D614G/N439K/P681R co-mutations were identified in its larger sub-lineage. The demographic history was inferred to have experienced four phases, with an exponential growth from October 2020 to February 2021. The effective reproduction number was estimated to have reached its peak (11.18) in late December 2020 and dropped to be less than one after early May 2021. The relevant phylogeography showed that Java and Sumatra might successively act as epi-centers and form a stable transmission loop. Additionally, several long-distance transmission links across seas were revealed.

CONCLUSIONS: SARS-CoV-2 variants circulating in the tropical archipelago may follow unique patterns of evolution and transmission. Continuous, extensive and targeted genomic surveillance is essential.

PMID:35710544 | DOI:10.1186/s12985-022-01830-1

Res Involv Engagem. 2022 Jun 16;8(1):26. doi: 10.1186/s40900-022-00360-y.

ABSTRACT

BACKGROUND: The Research Engagement Survey Tool (REST) was developed to examine the level of partner (e.g., patients, caregivers, advocates, clinicians, community members) engagement in research studies. The REST is aligned with eight engagement principles based on the literature and consensus reached through a five round Delphi process. Each of the engagement principles has three-five corresponding items that are assessed on two Likert type scales quantity (how often: never, rarely, sometimes, often, always, not applicable) and quality (how well: poor, fair, good, very good, excellent, not applicable). We conducted a comprehensive validation of the REST. Despite the importance of partner engagement in research, currently no gold standard measure exists.

METHODS: Multiple strategies were employed to validate the REST. Here, we examine the internal consistency of items for each of the eight engagement principles. In addition, we examine the convergent validity of the comprehensive (32-item) REST with other measures (e.g., medical mistrust, Community Engagement in Research Index, Partnership Self-Assessment Tool, Wilder collaboration inventory, Partnership Assessment In community-based Research). We propose two scoring approaches for the REST; one aligned with the engagement principles and the other aligned with levels of community engagement: (1) outreach and education, (2) consultation, (3) cooperation, (4) collaboration, and (5) partnership.

RESULTS: The REST has strong internal consistency (Cronbach’s alpha > 0.75) for each of the eight engagement principals measured on both scales (quality and quantity). The REST had negligible (e.g., medical mistrust, community engagement in research index), low (e.g., Partnership Assessment In community-based Research, Partnership Self-Assessment Tool- benefits scale), and moderate (e.g., Wilder collaboration inventory, Partnership Self-Assessment Tool- synergy scale) statistically significant correlations with other measures based on the Spearman rank correlation coefficient. These results suggest the REST is measuring something similar and correlated to the existing measures, but it captures a different construct (perceived research engagement).

CONCLUSIONS: The REST is a valid and reliable tool to assess research engagement of community health stakeholders in the research process. Valid tools to assess research engagement are necessary to examine the impact of engagement on the scientific process and scientific discovery and move the field of stakeholder engagement from best practices and lessons learned to evidence-based approaches based on empirical data.

PMID:35710531 | DOI:10.1186/s40900-022-00360-y

Infect Agent Cancer. 2022 Jun 16;17(1):31. doi: 10.1186/s13027-022-00443-1.

ABSTRACT

PURPOSE: Serum lactate dehydrogenase (LDH) concentration has been used for the evaluation and prediction of prognosis of several tumors, including hepatocellular carcinoma (HCC). However, the relationship between changes in LDH after treatment (ΔLDH) and prognosis is still unclear. Herein, we aimed to determine this association in patients with HCC.

METHODS: Multivariate adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for HCC were obtained by Cox proportional hazard regression models. As for ΔLDH and overall survival (OS), the nonlinear relationship was evaluated through a restricted cubic spline regression analysis, and threshold effects were further calculated using a two-piece-wise Cox proportional hazard model.

RESULTS: The study finally selected 749 patients with HCC treated by transarterial chemoembolization (TACE) for the secondary analysis. Considering the ΔLDH within ± 80 U/L group as the baseline, the risk of death in the ΔLDH ≥ 80 U/L group was significantly increased by 131% (95% CI: 1.74-3.06), and the risk of death in the ΔLDH ≤- 80 U/L group was increased by 24% (HR: 1.23, 95% CI: 0.99-1.55). However, this difference was not statistically significant. Furthermore, with ΔLDH = 0 (100 U/L) as the turning point, an upward U-shaped curve could be formed between ΔLDH and OS. After adjusting for confounders, ΔLDH still had a significant effect on the threshold of OS (P = 0.021).

CONCLUSION: After TACE, with the increase of LDH index, HCC patients will be closely related to worse OS.

PMID:35710505 | DOI:10.1186/s13027-022-00443-1

BMC Med Educ. 2022 Jun 17;22(1):469. doi: 10.1186/s12909-022-03460-1.

ABSTRACT

BACKGROUND: Constructivism theory has suggested that constructing students’ own meaning is essential to successful learning. The erroneous example can easily trigger learners’ confusion and metacognition, which may “force” students to process the learning material and construct meaning deeply. However, some learners exhibit a low level of elaboration activity and spend little time on each example. Providing instructional scaffolding and elaboration training may be an efficient method for addressing this issue. The current study conducted a randomized controlled trial to examine the effectiveness of erroneous example elaboration training on learning outcomes and the mediating effects of metacognitive load for Chinese students in medical statistics during the COVID-19 pandemic.

METHODS: Ninety-one third-year undergraduate medical students were randomly assigned to the training group (n = 47) and the control group (n = 44). Prerequisite course performance and learning motivation were collected as covariates. The mid-term exam and final exam were viewed as posttest and delayed-test to make sure the robustness of the training effect. The metacognitive load was measured as a mediating variable to explain the relationship between the training and academic performance.

RESULTS: The training significantly improved both posttest and delayed-test performance compared with no training (F_posttest = 26.65, p < 0.001, Partial η² = 0.23; F_{delayed test} = 38.03, p < 0.001, Partial η² = 0.30). The variation trend in metacognitive load in the two groups was significantly different (F = 2.24, p < 0.05, partial η² = 0.20), but metacognitive load could not explain the positive association between the treatment and academic performance (β = – 0.06, se = 0.24, 95% CI – 0.57 to 0.43).

CONCLUSIONS: Erroneous example learning and metacognitive demonstrations are effective for academic performance in the domain of medical statistics, but their underlying mechanism merits further study.

PMID:35710473 | DOI:10.1186/s12909-022-03460-1

Dent Mater. 2022 Jun 13:S0109-5641(22)00172-5. doi: 10.1016/j.dental.2022.06.021. Online ahead of print.

ABSTRACT

OBJECTIVES: Additive manufacturing (AM) is being applied to metallic biomaterials and dental alloys, including CoCrMo. CoCrMo mechanical properties and corrosion resistance are vital to the structural integrity of implants and dental appliances. The goal of this work is to assess the resistivity of AM cobalt chromium alloys by comparing them with traditional CoCrMo, regarding electrochemical properties resulting from microstructural and oxide film differences.

METHODS: In this work, selective laser melting (SLM), was used to manufacture CoCrMoW. The corrosion characteristics of AM alloy were compared to that of wrought LC CoCrMo (ASTM F-1537) in both phosphate buffered saline (PBS) and PBS with 10 mM H₂O₂ to simulate increased inflammatory conditions. Anodic polarization and electrochemical impedance spectroscopy (EIS) were performed.

RESULTS: Both alloys were substantially similar in corrosion behavior in both solutions. They exhibited changes with the different solutions. Polarization resistances were statistically lower (R_p^AM = 1.4 MΩcm² (PBS) vs. 0.72 MΩcm² (H₂O₂), R_p^LC = 1.86 MΩcm² (PBS) vs. 0.55 MΩcm² (H₂O₂)), and open circuit potentials (OCP’s) were statistically higher in 10 mM H₂O₂ for both alloys (0.20 V (in H₂O₂) vs. – 0.09 V in PBS). Chemistry variations were revealed by the corrosion tests indicating that wrought LC CoCrMo retained its casting-based chemical heterogeneity, while AM CoCrMoW had sub-cell structures within the solidified grains.

SIGNIFICANCE: As novel production methods like AM arise, it is necessary to understand any microstructural differences that may diminish the corrosion resistance properties. AM CoCrMoW alloys hold significant promise for use in dentistry where complex geometries are required.

PMID:35710472 | DOI:10.1016/j.dental.2022.06.021

J Biomech. 2022 May 30:111158. doi: 10.1016/j.jbiomech.2022.111158. Online ahead of print.

ABSTRACT

Bayesian methods have recently been proposed to solve inverse kinematics problems for marker based motion capture. The objective is to find the posterior distribution, a probabilistic summary of our knowledge and corresponding uncertainty about the model parameters such as joint angles, segment angles, segment translations, and marker positions. To date, Bayesian inverse kinematics models have focused on a frame by frame solution, which if repeatedly applied gives estimates that are discontinuous in time. We propose to overcome this limitation for continuous, planar inverse kinematics problems via the use of finite basis representations to model latent kinematic quantities as smooth, continuous functions. Our generalised smoothing approach is able to accurately approximate the solution to planar inverse kinematics problems defined by simple systems of ordinary differential equations in addition to considerably more complex systems such as a planar analysis of human gait. Improvements in accuracy are considerable with a decrease in average RMSE of 0.025 rad observed when estimating ankle joint angle for a randomly selected running stride with the proposed generalised smoothing approach compared to previous time-independent approaches. In addition, the generalised smoothing approach is able to effectively estimate kinematic parameters in the presence of missing data along with derivatives of kinematic quantities without the need for prior filtering or gap-filling of data.

PMID:35710465 | DOI:10.1016/j.jbiomech.2022.111158

Alzheimers Res Ther. 2022 Jun 16;14(1):83. doi: 10.1186/s13195-022-01026-3.

ABSTRACT

BACKGROUND: The literature has shown depression to be associated with an increased risk of dementia. In addition, hormone therapy can be a responsive treatment option for a certain type of depression. In this study, we examined the association between hormone therapy, including lifetime oral contraceptive (OC) use, and hormone replacement therapy (HRT) after menopause with the occurrence of dementia among female patients with depression.

METHODS: The South Korean national claims data from January 1, 2005, to December 31, 2018, was used. Female subjects aged 40 years or older with depression were included in the analyses. Information on hormone therapy was identified from health examination data and followed up for the occurrence of dementia during the average follow-up period of 7.72 years.

RESULTS: Among 209,588 subjects, 23,555 were diagnosed with Alzheimer’s disease (AD) and 3023 with vascular dementia (VD). Lifetime OC usage was associated with a decreased risk of AD (OC use for < 1 year: HR, 0.92 [95% CI, 0.88-0.97]; OC use for ≥ 1 year: HR, 0.89 [95% CI, 0.84-0.94]), and HRT after menopause was associated with a decreased risk of AD (HRT for < 2 years: HR, 0.84 [95% CI, 0.79-0.89]; HRT for 2-5 years: HR, 0.80 [95% CI, 0.74-0.88]; and HRT for ≥ 5 years : HR, 0.78 [95% CI, 0.71-0.85]) and VD (HRT < 2 years: HR, 0.82 [95% CI, 0.71-0.96]; HRT for 2-5 years: HR, 0.81 [95% CI, 0.64-1.02]; and HRT for ≥ 5 years: HR, 0.61 [95% CI, 0.47-0.79]).

CONCLUSIONS: In this nationwide cohort study, lifetime OC use was associated with a decreased risk of AD, and HRT after menopause was associated with a decreased risk of AD and VD among female patients with depression. However, further studies are needed to establish causality.

PMID:35710453 | DOI:10.1186/s13195-022-01026-3

J Cardiothorac Surg. 2022 Jun 16;17(1):158. doi: 10.1186/s13019-022-01915-6.

ABSTRACT

OBJECTIVE: Investigate the safety and efficacy of preoperative levosimendan in patients undergoing left ventricular assist device (LVAD) implantation.

METHODS: Consecutive patients who received LVADs (HeartMate-2, 3, HVAD) in a single tertiary medical center (2012-2018). INTERMACS profile 1 patients were excluded. The primary outcome was post-LVAD right ventricular failure (RVF) and inhospital mortality rates. The secondary outcomes included other clinical, echocardiographic and hemodynamic parameters at follow-up.

RESULTS: Final cohort consisted of 62 patients (40[65%] in the levosimendan group and 22[35%] in the no-levosimendan group). Post-operative RVF rate and inotrope or ventilation support time were similar in the levosimendan and no-levosimendan groups (7.5% vs. 13.6%; P = 0.43, median of 51 vs. 72 h; P = 0.41 and 24 vs. 27 h; P = 0.19, respectively). Length of hospitalization, both total and in the intensive care unit, was not statistically significant (median days of 13 vs. 16; P = 0.34, and 3 vs. 4; P = 0.44, respectively). Post-operative laboratory and echocardiographic parameters and in-hospital complication rate did not differ between the groups, despite worse baseline clinical parameters in the Levosimendan group. There was no significant difference in the in-hospital and long term mortality rate (2.5% vs. 4.5%; P > 0.999 and 10% vs. 27.3% respectively; P = 0.64).

CONCLUSIONS: Levosimendan infusion prior to LVAD implantation was safe and associated with comparable results without significant improved post-operative outcomes, including RVF.

PMID:35710438 | DOI:10.1186/s13019-022-01915-6

Hered Cancer Clin Pract. 2022 Jun 16;20(1):24. doi: 10.1186/s13053-022-00232-2.

ABSTRACT

BACKGROUND: Breast cancer is the most common malignancy in women, affecting over 1.5 million women every year, which accounts for the highest number of cancer-related deaths in women globally. Hereditary breast cancer (HBC), an important subset of breast cancer, accounts for 5-10% of total cases. However, in Low Middle-Income Countries (LMICs), the population-specific risk of HBC in different ethnicities and the correlation with certain clinical characteristics remain unexplored.

METHODS: Retrospective chart review of patients who visited the HBC clinic and proceeded with multi-gene panel testing from May 2017 to April 2020. Descriptive and inferential statistics were used to analyze clinical characteristics of patients. Fisher’s exact, Pearson’s chi-squared tests and Logistic regression analysis were used for categorical variables and Wilcoxon rank-sum test were used for quantitative variables. For comparison between two independent groups, Mann-Whitney test was performed. Results were considered significant at a p value of < 0.05.

RESULTS: Out of 273 patients, 22% tested positive, 37% had a VUS and 41% had a negative genetic test result. Fifty-five percent of the positive patients had pathogenic variants in either BRCA1 or BRCA2, while the remaining positive results were attributed to other genes. Patients with a positive result had a younger age at diagnosis compared to those having a VUS and a negative result; median age 37.5 years, IQR (Interquartile range) (31.5-48). Additionally, patients with triple negative breast cancer (TNBC) were almost 3 times more likely to have a positive result (OR = 2.79, CI = 1.42-5.48 p = 0.003). Of all patients with positive results, 25% of patients had a negative family history of breast and/or related cancers.

CONCLUSIONS: In our HBC clinic, we observed that our rate of positive results is comparable, yet at the higher end of the range which is reported in other populations. The importance of expanded, multi-gene panel testing is highlighted by the fact that almost half of the patients had pathogenic or likely pathogenic variants in genes other than BRCA1/2, and that our test positivity rate would have only been 12.8% if only BRCA1/2 testing was done. As the database expands and protocol-driven referrals are made across the country, our insight about the genetic architecture of HBC in our population will continue to increase.

PMID:35710434 | DOI:10.1186/s13053-022-00232-2

Reprod Health. 2022 Jun 16;19(1):139. doi: 10.1186/s12978-022-01448-0.

ABSTRACT

BACKGROUND: Early sexual debut among adolescent girls may result in teenage pregnancy and sexually transmitted diseases. In sub-Saharan Africa (SSA), pregnancy among adolescent girls may adversely impact the continuation of their education, general health status, and birth outcomes. However, few cross-national studies have examined the role that the social environment plays in adolescent girls’ sexual behaviors in SSA. In this study, we explored adolescent girls’ social environment and the impact on their sexual behaviors..

METHODS: The country selection was based on availability of Global School-Based Student Health Survey (GSHS) national data (2003-2015). The total analytic sample was 22,067 adolescent girls from 12 countries in SSA. Descriptive statistics were generated to determine the characteristics of adolescent girls and independent samples t-test analysis were performed to determine whether there were differences between the social environment and age of sexual debut and sexual partners. Logistic regression models were used to determine the association between adolescent girls’ social environment and sexual debut.

RESULTS: The study results showed variations across the 12 countries. Almost one in five (19.9%) adolescent girls reported to have ever engaged in sexual intercourse. Their mean age of sexual debut was 13.21 (13.04-13.37) years and mean number of sexual partners was 2.19 (2.08-2.29). We found that adolescent girls who reported not being connected with their parents were more likely to debut sex (aOR = 1.32, 95% CI, 1.14-1.53, p < 0.000). Parental monitoring was significantly associated with sexual debut but after controlling for the confounding variables (age, class grade and drug use), the association was no longer significantly positively associated. Adolescent girls who felt supported by their peers had a significantly higher number of sexual partners than those who did not feel supported by their peers.

CONCLUSION: The social environment of adolescent girls plays a very important role in sexual debut, age of sexual debut, and the number of sexual partners. Sexual health policies targeting adolescent girls are likely to achieve positive impacts if they focus on improving parental connectedness and peer support.

PMID:35710414 | DOI:10.1186/s12978-022-01448-0